Reflex and reflective testing strategies for early detection of pituitary dysfunction

Clinical Biochemistry
Manal ElnenaeiSyed Ali Imran

Abstract

The clinical presentation of pituitary dysfunction is typically variable and may often be insidious, resulting in delayed diagnosis by up to decades. The complexity of presentation and difficulty in pattern recognition of first line hormone tests result in challenges in early diagnosis of this condition. The aim of this study was to determine the impact of reflective testing and interpretive commenting on the early detection and management of such cases from primary care. Prospective audit over 12 months in which first line pituitary target organ hormones were identified via a reflex algorithm in the laboratory information system. Selected tests were reviewed by a laboratory clinician and decision made on reflective testing and interpretive commenting based on available clinical information and previous result trends. Patients who had a laboratory intervention were followed up to determine the clinical outcome. Out of 1099 patients identified, additional testing was made for 214. Interpretative comments were subsequently added to reports of 196 patients, 48 (25%) of whom were referred to endocrinology and 35 (73%) of these were directly related to the laboratory intervention. Eleven other patients had outcomes related to the in...Continue Reading

Citations

Oct 28, 2018·Clinical Chemistry and Laboratory Medicine : CCLM·Wytze Oosterhuis
Nov 5, 2019·Annals of Clinical Biochemistry·Gareth C McKeemanDanielle B Freedman
Oct 13, 2020·Annals of Clinical Biochemistry·Wytze P OosterhuisPatrick Mm Bossuyt
Jul 3, 2021·Diagnostics·Cornelia MrazekJanne Cadamuro

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